So what do you do again?!?!?!

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Specializes in Psychiatric Nursing.

******WARNING*****RANT*******

So in the past week I have had 2 separate occasions where patients of mine have been in need of a PA/MD consults and have been blown off... First I had a guy whos blood pressure drops to 36/48 (At what point do you stop profusing organs???) called the doc, no call back so I call the medical director who oversees the entire hospital and she tells me to recheck it in 2 hrs and call her back if it gets any worse. :madface: SERIOUSLY!?!?! Secondly, not quite so dire but still obnoxious is a lady of mine complaining of flank pain who had in the last week been treated for a UTI... the PA decides to do a repeate UA....that sounds prudent and fair. Another nurse comes in and tells the PA that the patient is specifically asking to be seen would he mind steping into her room for 5 min... he is nasty with her (the other nurse)... and then tells her that he does not see pts until we have screened them first... *** do u think we have been doing?!?! So he continues to sit around with staff and tell (INCREDIBLY STUPID) stories that are non-work related until he decides to leave the unit. Do ypu really think he was clocked off for story time, I doubt it, could he have not gone in and seen the patient? I mean really as doctors and physician assisatants I thought that they actually liked to asses patients so if not What do they do????? sorry, we really do have some amazing docs at the facility I work at but the few bad eggs sometimes can really spoil a friday night for ya. :angryfire

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Specializes in Cardiac Telemetry, ED.

36/48 must be a typo.

My understanding is that you stop perfusing vital organs when the MAP drops below 60.

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Specializes in ICU.

I hear your vent, but I have to say 36/48 is not a possible blood pressure.

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Specializes in ICU.

The bp must have been a typo.

Someone told me not too long ago,, that when a blood pressure is seriously low,, all it takes is ten minutes for permanent renal damage to occur. You should look that up on the internet.. and quote that do the doctor next time.

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Specializes in cardiac, ortho, med surg, oncology.
I hear your vent, but I have to say 36/48 is not a possible blood pressure.

It is a possible BP. My son has neurocardiogenic syncope and during his tilt table test his BP registered 42/26 before they placed him supine. He has had multiple syncopal events not only while upright but also while sitting and reclining due to these kinds of drops in his BP.

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Specializes in Emergency Department/Trauma.

I believe they were saying it wasn't possible to have the diastolic reading higher than the systolic reading, hence the typo remarks.

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I feel your pain! There are, in my opinion, certain people who should have never entered the medical profession. They seem to like the IDEA of being a doctor or nurse, but when it comes to actually dealing with patients, particularly the difficult ones, they will do everything in their power to avoid it. Unfortunately, these types usually drift off into "management" positions where they can take out their frustrations on the nurses who are actually at the frontline providing patient care. :twocents:

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Specializes in cardiac, ortho, med surg, oncology.
I believe they were saying it wasn't possible to have the diastolic reading higher than the systolic reading, hence the typo remarks.

Of course. Silly me!

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Specializes in Psychiatric Nursing.

sorry, your right... typo indeed.... must have been a bit heated at the time of posting.... 48/36 sounds a bit more correct eh... The pt. was VERY lethargic and would not take in any fluids. He was extremely psychotic and unable to concentrate on anything we were saying. after going in and agitating him with retaking his BP it went up to the 60s/40s but still the whole thing was really frustrating. Thanks for all your listening ears..... :redpinkhe

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Specializes in ED, ICU, PACU.

Can you get a rapid response team set up at your facility? With the story you just told, that would be reason enough to institute rapid response. Or, could you just call the ER when things like this happen? That would be a certain method to get some attention paid to the patients. And, if all else fails, maybe a 911 call might just wake someone up.

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Specializes in Psychiatric Nursing.

No rapid response available, actually at night when I work we do not have MDs/NPs/PAs on site they are only available by pager (which each night a different doc is oncall and suppose to be available within minutes) I don't work in a traditional medical hospital facility, its an acute care psychiatric hospital and when someone gets really bad we send them off in an ambulance. I have to admit calling 911 did cross my mind though :o. I think not having medical staff on site throughout the night is really a big oversite on my facilities part. Even if they had a nice bed set up in an On-call room in which the On Call would sleep most nights... patient safety first right???

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Specializes in Cardiac Telemetry, ED.

A BP of 48/36 is 911 worthy.

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